MR-guidance in clinical reality: current treatment challenges and future perspectives.
- Corradini S Department of Radiation Oncology, University Hospital, LMU Munich, Marchioninistraße 15, 81377, Munich, Germany. Stefanie.Corradini@med.uni-muenchen.de.
- Alongi F Department of Radiation Oncology, IRCSS Sacro Cuore don Calabria Hospital, Negrar-Verona, Italy.
- Andratschke N Department of Radiation Oncology, University Hospital Zürich, University of Zurich, Zürich, Switzerland.
- Belka C Department of Radiation Oncology, University Hospital, LMU Munich, Marchioninistraße 15, 81377, Munich, Germany.
- Boldrini L Istituto di Radiologia, Università Cattolica del Sacro Cuore, Rome, Italy.
- Cellini F Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario "A. Gemelli" IRCCS, UOC di Radioterapia Oncologica, Rome, Italy.
- Debus J Department of Radiation Oncology, Heidelberg University Hospital, Heidelberg, Germany.
- Guckenberger M Department of Radiation Oncology, University Hospital Zürich, University of Zurich, Zürich, Switzerland.
- Hörner-Rieber J Department of Radiation Oncology, Heidelberg University Hospital, Heidelberg, Germany.
- Lagerwaard FJ Department of Radiation Oncology, VU medical center, Amsterdam, The Netherlands.
- Mazzola R Department of Radiation Oncology, IRCSS Sacro Cuore don Calabria Hospital, Negrar-Verona, Italy.
- Palacios MA Department of Radiation Oncology, VU medical center, Amsterdam, The Netherlands.
- Philippens MEP Department of Radiation Oncology, University Medical Center Utrecht, Utrecht, The Netherlands.
- Raaijmakers CPJ Department of Radiation Oncology, University Medical Center Utrecht, Utrecht, The Netherlands.
- Terhaard CHJ Department of Radiation Oncology, University Medical Center Utrecht, Utrecht, The Netherlands.
- Valentini V Istituto di Radiologia, Università Cattolica del Sacro Cuore, Rome, Italy.
- Niyazi M Department of Radiation Oncology, University Hospital, LMU Munich, Marchioninistraße 15, 81377, Munich, Germany.
- 2019-06-07
Published in:
- Radiation oncology (London, England). - 2019
MR-guided radiotherapy, Image-guided, radiotherapy, MR-IGRT, MR-Linac, adaptive radiotherapy, Inter-fraction variability, Intra-fraction fraction variability, MRI, outcome
Humans
Magnetic Resonance Imaging
Neoplasms
Organs at Risk
Precision Medicine
Radiotherapy Dosage
Radiotherapy Planning, Computer-Assisted
Radiotherapy, Image-Guided
Radiotherapy, Intensity-Modulated
Reproducibility of Results
English
Magnetic Resonance-guided radiotherapy (MRgRT) marks the beginning of a new era. MR is a versatile and suitable imaging modality for radiotherapy, as it enables direct visualization of the tumor and the surrounding organs at risk. Moreover, MRgRT provides real-time imaging to characterize and eventually track anatomical motion. Nevertheless, the successful translation of new technologies into clinical practice remains challenging. To date, the initial availability of next-generation hybrid MR-linac (MRL) systems is still limited and therefore, the focus of the present preview was on the initial applicability in current clinical practice and on future perspectives of this new technology for different treatment sites.MRgRT can be considered a groundbreaking new technology that is capable of creating new perspectives towards an individualized, patient-oriented planning and treatment approach, especially due to the ability to use daily online adaptation strategies. Furthermore, MRL systems overcome the limitations of conventional image-guided radiotherapy, especially in soft tissue, where target and organs at risk need accurate definition. Nevertheless, some concerns remain regarding the additional time needed to re-optimize dose distributions online, the reliability of the gating and tracking procedures and the interpretation of functional MR imaging markers and their potential changes during the course of treatment. Due to its continuous technological improvement and rapid clinical large-scale application in several anatomical settings, further studies may confirm the potential disruptive role of MRgRT in the evolving oncological environment.
- Language
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- English
- Open access status
- gold
- Identifiers
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- DOI 10.1186/s13014-019-1308-y
- PMID 31167658
- Persistent URL
- https://sonar.ch/global/documents/94689
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